超声心动图评价二尖瓣位机械瓣口远期功能的探讨

目的：应用多普勒超声评价二尖瓣位机械瓣口的远期功能状况。方法：选择100例二尖瓣机械瓣置换术的患者，换瓣时间12～120个月，平均52个月。对比分析术后近期组（1～3年，30例）、中期组（3～5年，35例）和远期组（〉5年，35例）的二尖瓣口面积和最大压差。结果：与近期组比较，术后远期组机械瓣口舒张期跨二尖瓣口峰值血流速度（1．56±0．20）m／s比（1．78±0．35）m／s]、压力降半时间（80±0．36）s比（128±0．55）s]均显著增加，二尖瓣有效瓣口面积（2．75±0．18）cm^2比（1．72±0．45）cm^2]显著减少，P〈0．05或〈0．01；中期组和近期组比较，瓣口功能略有减退，但两者无显著差异（P〉0．05）。结论：二尖瓣机械瓣置换术患者机械瓣口面积有减少趋势。

Evaluation of long- term function of mechanical prosthetic valve on mitral position by Doppler echocardiography

Objective： To assess long- term function of mechanical prosthetic valve on mitral position by Doppler echo- cardiography. Methods..A total of 100 patients undergoing mitral mechanical valve replacement were selected. Their valve replacement time was 12- 120 months with a mean 52 months, valve orifice area of mitral orifice and maximum gradient pressure were compared and analyzed among short term group （1-3 years, n = 30）, medium term group （3-5 years, n = 35） and long term group （〉5 years, n = 35）. Results：Compared with short term group, there were significant increase in transmitral diastolic peak flow velocity （1.56 ±0.20） m/s vs. （1.78 ±0. 35） m/s] and pressure half-time （80 ±0.36） s vs. （128±0.55）s], and significant decrease in mitral effective orifice area （2. 75 ±0.18） cm^2 vs. （1.72 ±0.45） cm^2] of mechanical valve orifice in long-term group, P〈0. 05 or 〈0.01 ; Compared with short term group, valve orifice function of medium term group slightly degenerated but there was no significant difference, P〉0. 05. Conclusion： Mechanical valve orifice has recessive degeneration trend in patients undergoing mitral mechanical valve replacement.